The confluence of value-based care and population health

In the weeks leading up to the HIMSS 2018 conference in early March, I posted a question to the HIMSS community (45,000 strong in person at the conference and over 180,000 strong on the Linked In group), seeking to encourage conversation about the intersection of value-based care and population health.

How do we motivate people to become active participants in improving their health?

Implicit in that question are many other questions: What is it, exactly, that we are measuring? How do we know if a particular change is an improvement? How much of an improvement is enough? What are the incentives that are sufficient to move the various actors on the healthcare stage?

I think it is fair to say that the “science” of population health management should be considered to be under development. There are always further improvements that may be made.

A recurring conversation that I have been engaged in over the years revolves around the question of measures: What are we measuring? What are we incentivizing? Are we really buying better health through this approach to value-based payment for healthcare services?

We are certainly hurtling along the value-based care trajectory, and may not have the opportunity to make more that just a few mid-course corrections.

However, as we think about what future state we are trying to reach with these incentives, it is useful to think about health on a population level – not looking solely at patient-level or panel-level measures over time.

That really spoke to me, because it represents a step back from a tightly-quantified measure to a broader approach to social determinants of health (SDOH). There is a growing understanding that SDOH are foundational to patient and population health; that without taking care of the basics – food, shelter, clothing – delivering health care services is simply not enough.

With this background I ask you: What is your definition of population health and what are the tools we need to manage it more effectively?